Hollow upper eyelid - permanent solution?

Hyaluronic acid filler is the current best most reliable way of addressing this and this is a fussy service that requires maintenance.  Grafted fat causes unrepairable scaring and has never lived up to its promise no matter what you might read on certain websites on the internet.  There is no substitute for a personal consultation from a surgeon who devotes a significant part of their practice to fixing issues.  The presence of upper eyelid ptosis or prior eyelid surgery often sets the stage for better long term results in these cases.

Upper eyelid hollowness is a dramatically underappreciated, yet incredibly important component of aging in the eyelids. With normal aging, our upper eyelid fat pads tend to retract and expose this upper lid hollowness, those with “deep set eyes“ are especially prone, and unfortunately old-school upper eyelid surgery that is overly subtractive can artificially create this hollowness early, actually looking worse than it did before surgery - the before and after photo in the link below resulted from overly subtractive upper eyelid surgery with another surgeon, and you can see the results after revolumization of the upper lids. Correcting this hollowness can happen with filler injections into very specific planes of the upper eyelid, or transposing and rearranging the upper eyelid fat pads to provide fullness, as you see in this surgeon’s view video, borrowing the excess fat to move into the areas lacking fullness!


To ensure you are receiving the highest level of care, seek out a modernly trained, new-school dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these “core four” cosmetic specialties. Membership in organizations like the American Academy of Facial Plastic and Reconstructive Surgery help to identify a highly trained surgeon.


Cameron Chesnut
#realself100 Physician

Thank you for sharing your question. The permanent method for improving your hollowed eyes is with fat grafts. Dermal fillers work well too. The fat is permanent, but has a much higher complication rate. The fillers will last between 6-12 months. Find an experienced surgeon who specializes in eyelid surgery and the handling of complex cases. Good luck.